Therapist Reviewer

Therapist Reviewer

The Therapist Reviewer is provides comprehensive support and assistance to the faculty and staff in Fort Wayne, Indiana. This position is specifically dedicated to serve employees, with a hybrid work model both home and in schools. The ideal candidate will be a highly skilled, compassionate professional with a strong background in musculoskeletal health, physical therapy, or sports medicine. This role is pivotal in maintaining the well-being of our employees through preventative care, immediate consultation, and appropriate referrals.

How You Will Make An Impact:

• Applies professional therapy, government regulation, and medical policy knowledge to medical review, and makes determinations for authorization requests, meeting all contract requirements, processes and operational unit goals to ensure customer satisfaction.
• Documents findings, develops analyses, and submits reports to the appropriate departments in accordance with government regulations and requirements. Researches and obtains additional data, consults with clinical reviewers and medical directors, when necessary.
• Acts as a resource for internal and external customers.
• May participate in intradepartmental teams, projects, and initiatives.
• Maintains quality and productivity standards and ensures reviews are conducted within required timeframes.

Minimum Requirement:

• Requires graduate of a college level program in physical therapy or an accredited two year program for a Physical Therapist Assistant, and minimum of 1 year of clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Current active unrestricted license or certification as a physical therapist assistant in applicable state required.
• Certification and/or licensure appropriate to field of specialty as required.

Preferred Skills, Experience and Capabilities:

• Ability to travel throughout Fort Wayne market preferred.
• Background in orthopedic practice preferred.

Job Level: Non-Management Exempt

Job Family: MED > Licensed/Certified Allied Health Professional

Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.